埃塞俄比亚艾滋病毒感染者中异烟肼预防性治疗依从性的预测因素
Predictors of adherence to isoniazid preventive therapy in people living with HIV in Ethiopia.
作者信息
Ayele H T, van Mourik M S M, Bonten M J M
机构信息
Julius Center for Health Sciences and Primary Care, Infectious Diseases Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands; Dilla University College of Medicine & Health Sciences and Referral Hospital, Department of Public Health, Dilla, Ethiopia.
Department of Medical Microbiology and Infection Control, University Medical Center Utrecht, Utrecht, The Netherlands.
出版信息
Int J Tuberc Lung Dis. 2016 Oct;20(10):1342-1347. doi: 10.5588/ijtld.15.0805.
BACKGROUND
Although isoniazid preventive therapy (IPT) is effective in the prevention of tuberculosis (TB) in people living with the human immunodeficiency virus (PLHIV), patient adherence to this strategy is suboptimal.
METHODS
This prospective cohort study was conducted in the HIV/AIDS (acquired immune-deficiency syndrome) out-patient chronic care unit of Dilla University Hospital, Dilla, Ethiopia, from May 2014 to February 2015. Adherence was defined as completion of the 6-month course of treatment with 90% of pills taken, as measured by diary and pill count. Data were collected on potential predictors, including patients' demographic and clinical characteristics. Univariable and multivariable logistic regression models were fitted to identify independent predictors of adherence to IPT.
RESULTS
Of 162 PLHIV included, 104 (64.2%) were adherent to IPT. In the final multivariable model, concomitant use of antiretroviral therapy (ART) and/or cotrimoxazole preventive therapy (CPT) was associated with adherence to IPT (OR 2.66, 95%CI 1.15-6.17). Experiencing a high level of HIV stigma and episodes of opportunistic infections tended to be associated with non-adherence to IPT (OR 0.51, 95%CI 0.25-1.04 and OR 0.14, 95%CI 0.02-1.15) in comparison to low stigma and no opportunistic infections, respectively.
CONCLUSION
PLHIV receiving ART or CPT were more likely to adhere to IPT.
背景
尽管异烟肼预防性治疗（IPT）在预防人类免疫缺陷病毒（PLHIV）感染者的结核病（TB）方面有效，但患者对该策略的依从性欠佳。
方法
这项前瞻性队列研究于2014年5月至2015年2月在埃塞俄比亚迪拉市迪拉大学医院的艾滋病毒/艾滋病（获得性免疫缺陷综合征）门诊慢性病护理单元进行。依从性定义为完成6个月疗程且服药量达到90%，通过日记和药片计数来衡量。收集了包括患者人口统计学和临床特征在内的潜在预测因素的数据。采用单变量和多变量逻辑回归模型来确定IPT依从性的独立预测因素。
结果
纳入的162名PLHIV感染者中，104名（64.2%）对IPT治疗依从。在最终的多变量模型中，同时使用抗逆转录病毒疗法（ART）和/或复方新诺明预防性治疗（CPT）与IPT依从性相关（比值比2.66，95%置信区间1.15 - 6.17）。与低耻辱感和无机会性感染相比，高程度的艾滋病毒耻辱感经历和机会性感染发作往往与IPT不依从相关（比值比0.51，95%置信区间0.25 - 1.04；比值比0.14，95%置信区间0.02 - 1.15）。
结论
接受ART或CPT治疗的PLHIV感染者更有可能坚持IPT治疗。
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